Healthcare Provider Details

I. General information

NPI: 1811258155
Provider Name (Legal Business Name): ROXANNA M GARCIA AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2012
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 N TYSON AVE STE 100
FLORAL PARK NY
11001-1469
US

IV. Provider business mailing address

15350 89TH AVE APT 920
JAMAICA NY
11432-3891
US

V. Phone/Fax

Practice location:
  • Phone: 718-276-7935
  • Fax:
Mailing address:
  • Phone: 476-853-2403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number312238
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number656337
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: